Provider Demographics
NPI:1619922010
Name:FRIEDMAN, HARLEY PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:HARLEY
Middle Name:PAUL
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-653-9500
Mailing Address - Fax:603-650-6722
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DARTMOUTH-HITCHCOCK CLINIC
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-653-9500
Practice Address - Fax:603-650-6722
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10080207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0RE4589Medicaid
NH3072301Medicaid
VT0RE4589Medicaid
G54805Medicare UPIN
NHRE458901Medicare PIN